Beware! Mycoplasma pneumoniae has not gone away, and mixed infection has appeared again

Recently, the number of outpatient and emergency visits in many hospitals across the country has increased to varying degrees. Most of the patients are children. In addition to Mycoplasma pneumoniae infection, other diseases that cause respiratory infection symptoms are also on the rise.

Lu Hongzhou, director of the National Clinical Research Center for Infectious Diseases and president of Shenzhen Third People's Hospital, said that after the National Day, the results of nucleic acid tests for respiratory pathogens in patients at his hospital showed that the highest positive rate of nucleic acid tests was Mycoplasma pneumoniae (34.33%), followed by influenza A virus (12.17%) and influenza B virus (5.79%), respiratory adenovirus (2.76%), and respiratory syncytial virus (2.03%). He reminded that adenovirus and Streptococcus pneumoniae can be mixed with mycoplasma infection, and the younger the child, the greater the risk of mixed infection. If combined with mycoplasma infection, the child's symptoms will be aggravated, and parents should be vigilant.

In addition to Mycoplasma pneumoniae and the new coronavirus, what other infectious diseases should we pay attention to in the near future? How can we prevent them?

Influenza virus

Mycoplasma and influenza A and B have certain similarities, which leads to confusion among many people. Influenza A and B are caused by viruses, while mycoplasma is neither a bacterium nor a virus, but a type of microorganism. The drugs used for the two are completely different, so it is important to learn how to distinguish them.
Jiang Chunming, director of the Department of Pediatrics at Hangzhou First People's Hospital, said that there are some differences in the symptoms of infection between the two. The main symptoms of influenza A and B are high fever, sore throat, nasal congestion, fluid discharge, as well as body aches and headaches. Mycoplasma pneumoniae infection is more cunning. Children with Mycoplasma pneumonia do not necessarily have fever symptoms. Some children may only have a low fever or even no fever, and their blood routine and CRP are basically normal, which makes it easy to miss the diagnosis. However, Mycoplasma pneumoniae infection often leads to more severe coughing and even wheezing.

How to prevent it

Influenza vaccination is the most economical and effective measure to prevent influenza, and can significantly reduce the risk of contracting influenza and developing serious complications.

Respiratory syncytial virus

Respiratory syncytial virus is the most important viral pathogen causing acute lower respiratory tract infections in children under 5 years old worldwide. Respiratory syncytial virus is an RNA virus, and the dominant virus strain mutates every year, making it easy to get infected repeatedly. It is highly contagious and is mainly spread through coughing and droplets and close contact (such as touching or kissing an infected person). It can survive for several hours outside the body on contaminated tables, toys, etc.

Most healthy children infected with RSV will have mild and early symptoms similar to the common cold, with nasal congestion, cough, sneezing, runny nose, low-grade fever, etc. As the disease progresses, severe cases may experience breathing difficulties or shortness of breath, wheezing, irritability, loss of appetite, etc., and may even develop respiratory failure, heart failure, etc.

How to prevent it

People of all ages are susceptible to it, and it cannot be prevented by vaccines. The virus is seasonally prevalent. In northern my country, it is mainly prevalent from November to April of the following year (mostly in January and February). The virus incubation period is generally 2-8 days, and symptoms usually appear 4-6 days after infection. The virus is self-limiting, and for children with normal immune function development, family care can be provided for mild infection.

Rhinovirus infection

Rhinovirus is the most common human virus, with more than 120 serotypes identified so far. Rhinovirus is the main pathogen causing the common cold, and nearly half of acute respiratory infections are caused by rhinovirus infection.
Rhinovirus is common in the general population and is more common in children. The incubation period is 12 hours to 5 days, usually 48 hours. The disease can be transmitted through direct contact and droplets, or indirectly through hands and objects contaminated by nasal and throat secretions.

Rhinovirus usually resides in the upper respiratory tract, mainly causing common cold and other upper respiratory tract infections in adults; in addition to upper respiratory tract infections, it can also cause bronchitis and bronchopneumonia in infants and children and patients with chronic respiratory diseases. Clinical manifestations include runny nose, sneezing, throat discomfort, nasal congestion, cough, sore throat, hoarseness, and no or slightly elevated body temperature. Complications that are likely to occur include sinusitis and otitis media. It can cause mixed epidemic infections with enterovirus and Mycoplasma pneumonia in children.

How to prevent it

Common upper respiratory tract infections caused by rhinovirus are self-limiting and do not require special treatment. Standard protective measures such as getting more rest, eating a balanced diet, ventilating the living environment, improving hand hygiene, and preventing cross infection can be sufficient. The disease can be cured in about a week.

After rhinovirus infection, protective antibodies can be produced locally in the nasal mucosa, providing immunity to the same serotype strain, but the duration is often short-lived and cannot form lasting protection, so repeated infections can occur in the same year, but due to the mucosal immune training mechanism, subsequent infections tend to be mild. To date, there is still no effective vaccine to prevent rhinovirus infection.

Adenovirus infection

Adenovirus infection is mainly prevalent in winter and spring, and is prone to outbreaks in kindergartens and schools. Generally speaking, adenovirus is mainly transmitted through respiratory droplets, eye secretions, respiratory tract or contact; intestinal infection is mainly transmitted through the digestive tract.
Typical symptoms of adenovirus respiratory infection are cough, nasal congestion and pharyngitis, accompanied by fever, chills, headache and muscle aches, etc. Clinically, pharyngitis, pharyngoconjunctival fever, pneumonia, etc. may also occur. Some types of adenovirus can cause gastroenteritis in infants and preschool children, leading to abdominal pain, diarrhea, and even intussusception.

How to prevent it

Li Dongzeng, deputy chief physician of the infectious disease department of Beijing You'an Hospital affiliated to Capital Medical University, said that adenovirus infection is generally a self-limiting disease. People with normal immunity can recover on their own in about 7 days. They do not need to take medication. They just need to rest and drink plenty of water. However, some patients with low immunity or severe symptoms of adenovirus infection need to follow the doctor's advice and use antiviral drugs for treatment.

After adenovirus infection, protective neutralizing antibodies against this serotype can be obtained, thereby obtaining lasting immune protection against this serotype.

Streptococcus pneumoniae

Streptococcus pneumoniae is a bacterium that can adhere to and colonize the surface of the human upper respiratory tract for a long time without causing any clinical symptoms. It is the main pathogen that causes invasive diseases (meningitis, bacteremia/sepsis, pneumonia with bacteremia, etc.) and non-invasive diseases (pneumonia, otitis media and sinusitis). More than 50% of common pneumonia is caused by pneumococcus.

Infants and the elderly, especially those aged 65 and above, are very susceptible to pneumococcal infection due to their relatively poor immunity. Patients with chronic diseases such as chronic hepatitis, chronic heart disease, diabetes and people with low immune function are also susceptible to infection.

How to prevent it

Pneumococcal vaccination is the most economical and effective way to prevent pneumococcal diseases. Currently, the pneumococcal vaccines on the market include 23-valent and 13-valent pneumococcal vaccines (referring to the number of pneumococcal serotypes covered by the vaccine, respectively). The 23-valent pneumococcal vaccine is used for people over 2 years old who are at increased risk of pneumococcal infection and pneumococcal diseases, and the basic immunization is 1 shot. The 13-valent pneumococcal vaccine is for children aged 6 weeks to 5 years (before 6 years old), and can prevent pneumococcal diseases caused by 13 pneumococcal serotypes, especially invasive pneumococcal diseases. Up to now, these two types of pneumococcal vaccines are non-immunization program vaccines in most areas of my country.

In the fall and winter, children are more susceptible to a variety of viral and bacterial infections, which may cause a variety of different disease symptoms, such as fever, cough, runny nose, etc. Some symptoms may seem the same, but the causes and treatments are very different. However, some parents often diagnose their children's conditions at home and try to use medications on their own to deal with these symptoms. Doing so may not only lead to misdiagnosis and improper treatment, but may also make the condition worse, especially when children have co-infections, which are more likely to cause serious consequences. Therefore, it is recommended that parents should take their children to see a doctor in time and follow the doctor's advice for treatment. Professional doctors can give the most suitable treatment plan for their children based on their specific conditions and closely monitor changes in their children's conditions.

Emphasize again!

Wear a mask!

Source/People's Daily Online Science and Technology Comprehensive Dazhong Daily, Healthy China New Vision

Editor-in-charge: Song Wenzhen Editor of this issue: Li Huibo